Korean J Ophthalmol.  2005 Jun;19(2):122-127. 10.3341/kjo.2005.19.2.122.

Intraocular Pressure Elevation after Intravitreal Triamcinolone Acetonide Injection

• Park HY
• Yi K
• Kim HK

• KMID: 754409
• DOI: http://doi.org/10.3341/kjo.2005.19.2.122

Abstract

PURPOSE
This study investigated firstly the change of intraocular pressure (IOP) after injection of intravitreal triamcinolone acetonide (IVTA) for the treatment of macular edema and secondly the factors that influence these changes. METHODS: A prospective, non-comparative study was performed in 60 patients at Kangnam Sacred Heart Hospital from October 2003 to September 2004. All the patients received 4-mg IVTA injection. RESULTS: Mean IOP was elevated from the day after injection and peaked at 20.5 mmHg after 2 months (p=0.000). Twenty-six eyes (43.3%) showed significant IOP elevation. IOP was not controlled despite full glaucoma medication in 7 (11.7%) eyes. Two eyes underwent filtering surgery. Younger age was a statistically significant predictive factor for IOP elevation (p=0.009). CONCLUSIONS: In this study, patients who needed filtering surgery developed an IOP spike within one week after the injection. Therefore, clinicians should consider checking IOP at the end of the first week. Furthermore, greater cautions is mandatory with relatively younger patients.

Keyword

Intravitreal triamcinolone acetonide (IVTA) injection; Intraocular pressure (IOP) ; Younger age

MeSH Terms

Adult
Aged
Aged, 80 and over
Female
Glucocorticoids/*administration & dosage/*adverse effects/therapeutic use
Humans
Injections
Intraocular Pressure/*drug effects
Macular Edema, Cystoid/*drug therapy/*physiopathology
Male
Middle Aged
Prospective Studies
Triamcinolone Acetonide/*administration & dosage/*adverse
Vitreous Body

Figure

• 

  Fig. 1. Distribution of mean intraocular pressure (IOP) after 4-mg intravitreal triamcinolone acetonide injection in 60 patients, 60 eyes. A: group of patients with normal IOP (N=34). B: group of patients with postoperative IOP elevation (N=26).

• 

  Fig. 2. Distribution of intraocular pressure (IOP) in patients with uncontrolled IOP (N=7). a,b: recovered to normal range of IOP during the long term follow-up period. c,d: were lost during the follow-up period and further observation was not available. e.f: showed persistent ocular hypertension despite full glaucoma medication and required filtering surgery to control IOP. After conventional penetrating glaucoma surgery, IOP was normalization. g: even though topical glaucoma medication was performed due to IOP elevation, IOP fluctuation continued for several months and the patient was still on follow-up at the time of writing. (number): patients age, ◇: date of trabeculectomy

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